Eye health resource
Most Common Pediatric Eye Exam Questions
Answers to common parent questions about pediatric eye exams, including when children should be examined, what tests are used, whether dilation is needed, and what happens if a vision problem is found.
Reviewed for accuracy by Justin Bazan, OD on .
Parents often wonder how an eye doctor can examine a baby or young child who cannot read letters, whether school screening is enough, and how often children really need a full eye exam. The short answer is that pediatric eye exams are designed around the child's age and abilities.
When Should My Child Have an Eye Exam?
For children who are asymptomatic and low risk, the American Optometric Association recommends a comprehensive assessment at 6 to 12 months, at least one exam between ages 3 and 5, and an exam before first grade and annually thereafter.
A child with symptoms, a failed screening, a known eye condition, developmental or medical risk factors, significant family history, or a parent or pediatrician concern may need evaluation sooner or more often.
Park Slope Eye participates in InfantSEE, and qualifying InfantSEE infant assessments are available at no charge during the first year of life.
Does My Child Need to Know Letters?
No. Babies and young children can be examined with objective testing, pictures, symbols, lights, toys, and observation of how the eyes fixate, follow, focus, and work together.
As children get older, the exam can incorporate more subjective responses, but knowing the alphabet is not a requirement for meaningful pediatric eye care.
What Does a Pediatric Eye Exam Check?
Depending on age and the reason for the visit, the examination can assess:
- visual acuity or age-appropriate visual behavior;
- nearsightedness, farsightedness, and astigmatism;
- eye alignment and eye movements;
- focusing and how the eyes work together;
- pupil responses;
- the health of the front and back of the eyes; and
- risk factors from medical, birth, developmental, and family history.
Why Does Family and Medical History Matter?
Some eye and vision problems are more likely in children with particular family histories, medical conditions, premature birth, developmental concerns, or prior eye problems. That context helps the doctor decide what to look for and whether a child should be followed more frequently.
Tell the doctor about known eye disease in close relatives, significant childhood prescriptions, crossed or wandering eyes, amblyopia, retinal disease, genetic conditions, premature birth, major medical diagnoses, and anything else that may affect vision development.
Will My Child Need Dilating Drops?
Sometimes. Dilation can help the doctor obtain a more complete internal eye-health view and can also help measure a child's refractive error when normal focusing would otherwise make the result less reliable.
Many children around age 5 and older also do very well with Park Slope Eye's Optos wide-angle retinal imaging. It creates a fast, non-contact photograph of much of the retina and often provides useful retinal documentation without routine dilation. Imaging does not eliminate the need for dilation in every child, and we will explain when we think drops are clinically important.
What If My Child Needs Glasses?
If an eyeglass prescription would help, we will explain what the prescription means and how strongly we recommend that it be worn. The prescription belongs to you; buying glasses from Park Slope Eye is not required to receive it.
Our optical carries independent frame brands as well as children's eyewear, and we are happy to provide a quote if you would like us to make the glasses.
What If My Child Is Nearsighted?
Myopia means nearsightedness. If myopia is progressing, Park Slope Eye can discuss myopia-management options such as Ortho-K, low-dose atropine, or appropriate soft multifocal/myopia-control contact lenses. Treatment is individualized and no option can guarantee that progression will stop.
Is a School Vision Screening Enough?
Screenings are useful for identifying some children who may need further evaluation, but they are not the same as a comprehensive eye exam. A child can pass a screening and still have an eye-health, focusing, binocular-vision, or refractive issue that deserves attention.
For more information, see pediatric eye care at Park Slope Eye or book an appointment online.
Originally published . Substantially updated .